Læknablaðið : fylgirit - 01.06.2009, Blaðsíða 25

2 7 T H CONGR SCAND ASSOC UROL
F Y L G I R I T 6 1
Gleason score pre-EBRT:
Gleason score 3+3 3+4 4+3 4+4 5+4 Unknown WH01 WH0 2
N 7 2 2 4 1 3 1 3
Clinical stage pre-EBRT:
Clinical T-stage T1 T2 T3 Unknown
Number of patients 3 4 14 2
Nadir PSA post-EBRT was 0.7 ± 0.7 ng/ml. Mean time between
EBRT and HIFU was 76 ± 42 months. Mean prostate volume pre-
HIFU was 20.0 ± 6.2 ml.
Mean PSA pre-HIFU was 4.9 ± 4.7 ng/ml. Mean follow-up was 6
months (range 3-18 months).
Results: Mean post-HIFU was PSA 0.9 ± 1.4 ng/ml. There
were nine failures (39%) defined as PSA nadir >0.5 ng/ml.
There was one case of urethro-rectal fistulae which was treated
conservatively with prolonged urinary bladder catheter. There
were three patients on endocrine treatment pre-HIFU, all of
whom are without endocrine treatment at the time of follow-up.
Conclusion: Our patient material so far is quite small and the
follow-up periods are too short for significant conclusions. In
selected patients with good initial prognosis, HIFU seems to be
a viable salvage treatment option with a curative intent with an
acceptable morbidity.
47 HIFU treatment as primary treatment of localized
prostate cancer
V Berge, E Baco, SJ Karlsen
Oslo Urological University Clinic (OUU), Aker University Hospital, Oslo,
Norzvciy
viktbe@online.no
Aim: To evaluate the efficacy and safety of HIFU as primary
treatment of prostate cancer.
Material and methods: Our patients consisted of men not suit-
able for standard curative treatments (radical surgery or radia-
tion treatment) or patients not willing to undergo standard treat-
ment. During June 2006 and December 2007 16 patients were
treated, 13 of whom have adequate follow-up to date. Mean age
69.4 ± 6.7 years. Median PSA was 7.5 ng/ml at diagnosis (range
1.5 - 546). Mean prostate volume was 22.8 ± 6.3 ml. Mean fol-
low-up was 12 months (range 6-24 months).
Gleason score 3+3 3+4 4+3 4+4
Number of patients 7 3 1 2
Clinical T-stage T1 T2 Unknown
Number of patients 6 6 1
Results: Mean PSA 1.8 ± 2.3 ng/ml. So far there have been two
patients with PSA recurrence defined as PSA nadir + 2.0 ng/ml
and two patients had a positive rebiopsy. One of these patients
had re-treatment with HIFU and PSA is now stable. There were
no urethro-rectal fistulas.
Conclusion: Our patient material so far is quite small and the
follow-up periods are too short for significant conclusions.
However, for selected patients primary HIFU may be curative
with an acceptable morbidity.
48 Captopril may reduce PSA-relapse after
laparoscopic radical prostatectomy
YH Wang, G Frithz, T Lindeborg, G Ronquist G
Dept. ofSurgery and Urology, Dept. oflntemal Medicine, Miiiar Hospital, and
Dept. ofMedical Sciences, Clinical Chemistry, University Hospital, Uppsaia,
Sweden
info@drwang.se
Aim of investigation: Captopril being an inhibitor of angiotensin
I-converting enzyme was associated with a substantially reduced
risk of developing prostate cancer. About 30 % of the patients
will have PSA relapse after laparoscopic radical prostatectomy
(LRP). The aim of the present study was to investigate, whether
captopril given in a low dose postoperatively can reduce PSA-
relapse after LRP.
Materials and methods: A total of 62 patients, who underwent
LRP by a single surgeon in one centre since 2000, were divided
into two groups according to the date of birth. 32 patients
with odd number of birthday received captopril 12.5 mg
twice daily (captopril group) and other 30 did not receive the
medicine (control group). Three were no significant differences
in patients' ages, prostate volume, pre-op PSA, Gleason score,
operation time, and blood loss between these 2 groups. All
patients were followed up in accordance with a study protocol
more than 3 years.
Results: No patients died of prostate cancer in any of the
two groups. There patients had PSA-relapse in the captopril
group while 10 patients had PSA-relapse in the control group
(p=0.034). Mean follow-up time was 38 months.
Conclusions: A significantly lower rate of PSA-relapse was
observed in 32 men receiving captopril postoperatively
compared to a control group of men not receiving captopril.
Because of little side effects and low costs, further enlarged
multicenter studies are warranted.
49 Bisphosphonate (Zoledronic acid) induced
osteonecrosis of the jaw
A Haidar1, M Jonler1, TB Folkmar2, L Lund1
Department ofUrology’, Department ofOral and Maxillofacial Surgery2, Viborg
Hospital, Denmark
dr.ll@dadlnet.dk
Introduction: The use of biphosphonates (Zoledronic acid) in
the treatment of metastatic bone disease has been on the rise
during the last few years. The aim of this treatment is mainly
to reduce skeletal related events e.g. pain, pathologic fractures.
There have been few reports relating osteonecrosis of the jaw to
treatment with biphosphonates.
Material and methods: In a retrospective study we reviewed
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